Endoscopy and gastroenterology.
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Curriculum↗
Biomedical subjects
S H Lorber
Publications and source records attributed to S H Lorber.
Symptom dynamics.
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Deglutition Disorders↗
Effects of glucagon and secretin on food- or morphine-induced motor activity of the distal colon, rectum, and anal sphincter.
The effects of glucagon and secretin on food- or morphine-induced motor activity of the distal colon, rectum, and internal anal sphincter were investigated in 12 healthy subjects. Intraluminal pressure changes were measured using a triple-lumen polyvinyl tube assembly with 3 side orifices. Glucagon, administered intravenously, caused significant inhibition of food- or morphine-induced motor activity of both the distal colon and rectum. In contrast, secretin did not suppress morphine-induced motor activity but did significantly inhibit food-stimulated motor activity of the distal colon. The inhibitory effect of secretin on motor activity of the rectum was insignificant. Morphine, but not food, elevated the pressure of the anal sphincter which was not effected by glucagon or secretin. Hyperglycemia, produced by the infusion of 5% glucose, had no effect on motor activity. These studies demonstrate that glucagon but not secretin, in the doses employed, inhibits morphine-induced motor wave activity of both the distal colon and rectum and that this inhibitory effect is not secondary to hyperglycemia. Furthermore, the rise in anal sphincter pressure is not affected by glucagon or secretin.
Adult↗
Hemangioendotheliomatosis of the liver. A 12-year follow-up.
Hemangioendothelioma of the liver is a rare tumor. A case is reported of a middle-aged woman who presented with hepatomegaly and ascites, and who has been followed for over 12 years. The clinical features, pathological, radiographic, portal hemodynamic, and metabolic changes are presented.
Adult↗
Endoscopic polypectomy from the afferent duodenal loop.
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Aged↗
Upper gastrointestinal hemorrhage clinical, radiological and endoscopic correlation of 100 consecutive cases.
One hundred consecutive cases of upper gastrointestinal hemorrhage were studied clinically, radiologically and endoscopically. Erosive gastritis, duodenal and gastric ulcer, and bleeding esophageal varices accounted for 85% of the cases. The presenting sign of hematamesis or melena was of no value in localizing the bleeding site relative to the pyloric sphincter. Erosive lesions of the esophagus and stomach were suspected clinically in less than 50% of the cases and were the lesions least amenable to radiologic diagnosis and where early endoscopy was most useful. Our observations demonstrate again the frequent association between ethanol or aspirin ingestion and erosive gastritis.
Adult↗
Characterization of a hyperactive segment at the rectosigmoid junction.
During a study of intraluminal motor patterns of the colon and rectum, spontaneous wave activity of a continuous complex type was observed at the rectosigmoid junction in constipated subjects. To assess the frequency and characteristics of this hyperactive segment, 36 subjects with colonic motor disorders and 12 healthy controls were studied. Eighteen of 24 patients with constipation (75%) and 1 of 7 subjects with asymptomatic diverticulosis exhibited a persistent hyperactive segment at the rectosigmoid junction. Neither secretin nor cholecystokinin influenced the wave activity of the hyperactive segment. In contrast, atropine and glucagon inhibited markedly all wave activity and decreased the motility index of this segment significantly, suggesting overactivity of the muscarinic effector cells. It is concluded that a segmental area of overactivity exists at the rectosigmoid junction in most constipated subjects regardless of their underlying disorders.
Adult↗
The effect of glucagon on cholinomimetic responses of the recto-sigmoid.
Motor activity of the lower bowel was induced by the parenteral administration of prostigmine or bethanechol in 7 subjects. Intraluminal pressure recordings from the sigmoid colon and rectum revealed that the augmented responses of motor activity to these cholinomimetic drugs were similar both in duration and in motility indexes. The intravenous administration of glucagon inhibited the motor responses to both cholinomimetic stimuli employed. A possible mechanism for the inhibitory action of glucagon is suggested and the clinical application of these observations is discussed.
Adult↗